Proximally (above the knee joint) the femur joins with the pelvis to make up the iliofemoral joint. The pelvis and sacrum join to make the sacroiliac joint.

Distally (below the knee joint), the tibia and fibula help form the ankle (talocrural) joint.

Muscles

There are a number of muscles in the lower leg and lumbo-pelvic-hip complex that can influence the knee.

Gastrocnemius/Soleus (posterior lower leg)

Adductors (Inner thigh)

Hamstrings (Posterior thigh)

Tensor fascia latae/IT- Band (Anterior and Lateral hip and thigh)

Quadriceps (anterior thigh and hip)

Gluteal muscles (Posterior and lateral hip)

It is essential that these muscles have optimum length, tension and strength to ensure optimum flexibility, range of motion and neuromuscular control.

Common knee Injuries Associated With Movement Deficiencies

Patellar Tendinopathy (Jumper’s Knee)

Repeated stress from overuse on the patellar tendon results in inflammation and degeneration

Increase risk from knee valgus (knock-knee) or knee varus (Bow-leg)

Poor quadricep and hamstring flexibility can lead to increased risk

Women more susceptible (8x) due to an increase in the Q angle (a measurement of the angle between the quadriceps muscles and the patella tendon that provides information about the alignment of the knee joint)

Iliotibial Band Syndrome (Runner’s knee)

Inflammation of the distal part of the iliotibial tendon as it inserts into the outer part of the femur at the knee joint or less commonly proximally at the hip, where it can cause bursitis

Common in runners, cyclists and tennis players, as an overuse injury

Factors such as an over active Tensor fascia latae pulling on the IT- Band, as well as weakness in the hip abductors, greatly influence proper mechanics, resulting in friction and eventually inflammation

Patellofemoral Syndrome

Abnormal tracking of the patella due to altered activation of the muscle surrounding the knee as well as weakness in the hip musculature (Gluteus medius and maximus)

Patella tracking can also be affected by an abnormal Q-angle

Anterior Cruciate Ligament (ACL) Injury

Commonly due to altered or insufficient lower extremity neuromusculoskeletal control from muscle imbalances and joint misalignments (Pelvis, knee and ankle)

Valgus torque (knees tending more towards adduction, which is more common in women), affects frontal plane stability (side to side movements) and greatly increases the risk of injury during side-to-side movement and landing from a jump